检索结果-南通市图书馆

World Journal of Gastroenterology 2018年第21期24卷 2291-2299页

作者： Sergey Morozov Vasily Isakov Mariya Konovalova department of Gastroenterology and Hepatology Federal Research Center of NutritionBiotechnologyand Food SafetyMoscow 115446Russia

AIM To investigate the effect of dietary fiber on symptoms and esophageal function testing parameters in nonerosive gastroesophageal reflux disease(GERD)(NERD) patients.METHODS Thirty-six NERD patients with low(non-parametric statistics(Wilcoxon matched pairs test). RESULTS The number of patients experiencing heartburn was less(93.3% at baseline vs 40% at the end of the study, P < 0.001) and the GERD-Q score decreased(mean ± SD: 10.9 ± 1.7 vs 6.0 ± 2.3, P < 0.001) after the treatment period. Minimal resting lower esophageal sphincter(LES) pressure increased from 5.41 ± 10.1 to 11.3 ± 9.4 mm Hg(P = 0.023), but no change in residual LES pressure and mean resting pressure was found. Total number of gastroesophageal refluxes(GER) decreased from 67.9 ± 17.7 to 42.4 ± 13.5(P < 0.001) predominantly by acid and weak acid types of GERs. No significant change in mean esophageal p H and % of time p H < 4 was registered. Maximal reflux time decreased from 10.6 ± 12.0 min to 5.3 ± 3.7 min(P < 0.05). CONCLUSION Fiber-enriched diet led to a significant increase of minimal lower esophageal sphincter resting pressure, a decrease of number of gastroesophageal refluxes, and a decrease of heartburn frequency per week in NERD.

关键词： gastroesophageal reflux disease psyllium gastroesophageal reflux lower esophageal sphincter relaxation esophageal motility Dietary fiber heartburn non-erosive gastroesophageal reflux disease

Risk factors for proton pump inhibitor refractoriness in Chinese patients with non-erosive reflux disease

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2013年第20期19卷 3124-3129页

作者： Xiao-Ping Niu Bao-Ping Yu Yun-Dong Wang Zhen Han Shao-Fen Liu Chi-Yi He Guo-Zheng Zhang Wan-Chun Wu Department of Gastroenterology Yijishan HospitalWannan Medicine College Department of Gastroenterology Renmin HospitalWuhan University

AIM:To analyze risk factors for refractoriness to proton pump inhibitors(PPIs) in patients with non-erosive reflux disease(NERD).METHODS:A total of 256 NERD patients treated with the PPI esomeprazole were enrolled.They were classified into symptom-free and residual symptoms groups according to Quality of Life in Reflux and Dyspepsia(QolRad) scale.All subjects completed questionnaires on psychological status(self-rating anxiety scale;selfrating depression scale) and quality of life scale(Short Form 36).Multivariate analysis was used to determine the predictive factors for PPI responses.RESULTS:According to QolRad,97 patients were confirmed to have residual reflux symptoms,and the remaining 159 patients were considered symptom free.There were no significant differences between the two groups in lifestyle factors(smoking and alcohol consumption),age,Helicobacter pylori infection,and hiatal hernia.There were significant differences between the two groups in relation to sex,psychological distress including anxiety and depression,body mass index(BMI),and irritable bowel syndrome(IBS)(P < 0.05).Logistic regression analysis found that BMI < 23,comorbid IBS,anxiety,and depression were major risk factors for PPI resistance.Symptomatic patients had a lower quality of life compared with symptom-free patients.CONCLUSION:Some NERD patients are refractory to PPIs and have lower quality of life.Residual symptoms are associated with psychological distress,intestinal disorders,and low BMI.

关键词： Risk factors Refractoriness Proton pump inhibitors non-erosive reflux disease

Autofluorescence imaging endoscopy can distinguish non-erosive reflux disease from functional heartburn: A pilot study

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2016年第14期22卷 3845-3851页

作者： Xi Luo Xiao-Xu Guo Wei-feng Wang Li-hua Peng Yun-sheng Yang Noriya Uedo Department of Gastroenterology and Hepatology Chinese PLA General Hospital Department of Gastrointestinal Oncology Osaka Medical Center for Cancer and Cardiovascular Diseases

AIM: To investigate whether autofluorescence imaging(Af I) endoscopy can distinguish non-erosive reflux disease(NERD) from functional heartburn(fh).METHODS: In this prospective observational trial, 127 patients presenting with typical reflux symptoms for > 6 mo were screened. All the participants underwent endoscopy, during which white light imaging(WLI) was followed by Af I. finally 84 patients with normal esophageal appearance on WLI were enrolled. It was defined as being suggestive of NERD if one or more longitudinal purple lines longer than one centimeter were visualized in the distal part of the esophagus during Af I endoscopy. Ambulatory 24-h multichannel intraluminal impedance and ph monitoring was also performed. After standard proton-pump inhibitor(PPI) tests, subjects were divided into an NERD group and an fh group and the diagnostic performance of Af I endoscopy to differentiate NERD from fh was evaluated.RESULTS: Of 84 endoscopy-negative patients, 36(42.9%) had a normal ph/impedance test. Of these, 26 patients with favorable responses to PPI tests were classified as having NERD. finally 10 patients were diagnosed with fh and the others with NERD. Altogether, 68(81.0%) of the 84 patients were positive on Af I endoscopy. In the NERD group, there were 67(90.5%) patients with abnormal esophageal findings on Af I endoscopy while only 1(10%) patient was positive on Af I endoscopy in the fh group. The sensitivity and specificity of AFI in differentiating NERD from FH were 90.5%(95%CI: 81.5%-96.1%) and 90.0%(95%CI: 55.5%-99.7%), respectively. Meanwhile, the accuracy, positive predictive value and negative predictive value of Af I in differentiating between NERD and fh were 90.5%(95%CI: 84.2%-96.8%), 98.5%(95%CI: 92.1%-99.9%) and 56.3%(95%CI: 30.0%-80.2%), respectively.CONCLUSION: Autofluorescence imaging may serve as a complementary method in evaluating patients with NERD and fh.

关键词： Gastroesophageal reflux disease White light imaging non-erosive reflux disease functional heartburn

Proton pump inhibitor for non-erosive reflux disease:A meta-analysis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2013年第45期19卷 8408-8419页

作者： Ji-Xiang Zhang Meng-Yao Ji Jia Song Hong-Bo Lei Shi Qiu Jing Wang Ming-Hua Ai Jun Wang Xiao-Guang Lv Zi-Rong Yang Wei-Guo Dong Department of Gastroenterology Renmin Hospital of Wuhan University

AIM:To evaluate the efficacy,safety and influential factors of proton pump inhibitor(PPI)treatment for non-erosive reflux disease(NERD).METHODS:PubMed,MEDLINE,EMBASE and the Cochrane Library were searched up to April 2013 to identify eligible randomized controlled trials(RCTs)that probed into the efficacy,safety and influential factors of PPI treatment for NERD.The rates of symptomatic relief and adverse events were measured as the outcomes.After RCT selection,assessment and data collection,the pooled RRs and 95%CI were calculated.This meta-analysis was performed using the Stata 12.0 software(Stata Corporation,College Station,Texas,United States).The level of evidence was estimated by the Grading of Recommendations Assessment,Development and Evaluation system.RESULTS:Seventeen RCTs including 6072 patients met the inclusion criteria.The results of the metaanalysis showed that PPI treatment was significantly superior to H2receptor antagonists(H2RA)treatment(RR=1.629,95%CI:1.422-1.867,P=0.000)and placebo(RR=1.903,95%CI:1.573-2.302,P=0.000)for the symptomatic relief of NERD.However,there were no obvious differences between PPI and H2RA(RR=0.928,95%CI:0.776-1.110,P=0.414)or PPI and the placebo(RR=1.000,95%CI:0.896-1.116,P=0.997)regarding the rate of adverse events.The overall rate of symptomatic relief of PPI against NERD was 51.4%(95%CI:0.433-0.595,P=0.000),and relief was influenced by hiatal hernia(P=0.030).The adverse rate of PPI against NERD was 21.0%(95%CI:0.152-0.208,P=0.000),and was affected by hiatal hernia(P=0.081)and drinking(P=0.053).CONCLUSION:PPI overmatched H2RA on symptomatic relief rate but not on adverse rate for NERD.Its relief rate and adverse rate were influenced by hiatal hernia and drinking.

关键词： Proton pump inhibitor non-erosive reflux disease Symptomatic relief Adverse event Meta-analysis

Characteristics of symptomatic reflux episodes in Japanese proton pump inhibitor-refractory non-erosive reflux disease patients

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2015年第47期21卷 13352-13359页

作者： Kenichiro Nakagawa Tomoyuki Koike Katsunori Iijima Masahiro Saito Hiroki Kikuchi Waku Hatta Nobuyuki Ara Kaname Uno Naoki Asano Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of Medicine

AIM: To clarify the pathogenesis of gastroesophageal reflux disease symptoms in non-erosive reflux disease(NERD) patients.METHODS: Thirty-five NERD patients with persistent symptoms, despite taking rabeprazole 10 mg twice daily for at least 8 wk, were included in this study. All patients underwent 24 h combined impedance- p H on rabeprazole. The symptom index(SI) was considered to be positive if ≥ 50%, and proximal reflux episodes were determined when reflux reached 15 cm above the proximal margin of the lower esophageal sphincter.RESULTS: In 14(40%) SI-positive patients, with liquid weakly acid reflux, the occurrence rate of reflux symptoms was significantly more frequent in proximal reflux episodes(46.7%) than in distal ones(5.7%)(P < 0.001). With liquid acid reflux, there were no significant differences in the occurrence rate of reflux symptoms between proximal reflux episodes(38.5%) and distal ones(20.5%)(NS). With mixed liquid-gas weakly acid reflux, the occurrence rate of reflux symptoms in proximal reflux episodes was significantly more frequent(31.0%) than in distal reflux ones(3.3%)(P < 0.001). With mixed liquid-gas acid reflux, there were no significant differences in the occurrence rate of reflux symptoms between proximal reflux episodes(29.4%) and distal ones(14.3%)(NS).CONCLUSION: The proximal extent of weakly acidic liquid and mixed liquid-gas reflux is a major factor associated with reflux perception in SI-positive patients on proton pump inhibitor therapy.

关键词： Proton pump inhibitor Symptomatic refluxepisodes Proximal reflux non-erosive reflux disease Impedance-pH monitoring

Therapeutic Advantages of Traditional Chinese Medicine in non-erosive Reflux Disease

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Integrated Traditional and Western Medicine 2018年第2期4卷 6-12页

作者： Che Hui Xie Jingyi Ma Xiangxue Tang Xudong Wang Fengyun Xiyuan Hospital of China Academy of Chinese Medical Sciences (CACMS) 不详

The incidence of gastroesophageal reflux disease(GERD) is increasing year by year. non-erosive reflux disease(NERD) is not only the most common subtype of GERD, but also has the highest proportion of refractory GERD. The pathogenesis may be closely related to mixed reflux, non-acid reflux, esophageal hypersensitivity, psychology and so forth. On the one hand, the treatment with acid suppression drugs alone has a high recurrence rate, and the maintenance treatment continues to be controversial. On the other hand, the comprehensive treatment with the traditional Chinese medicine(TCM), which is based on a number of hybrid mechanisms, is more prominent in individualization with more advantages in long-term efficacy and improvement of quality of life for the patient. The authors conduct a comprehensive analysis on characteristics of NERD and advantages of TCM in treatment, in order to provide more ideas for clinical treatment.

关键词： Gastroesophageal reflux disease non-erosive reflux disease TCM advantage

non-erosive and uncomplicated erosive reflux diseases:Difference in physiopathological and symptom pattern

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Pathophysiology 2011年第3期2卷 42-48页

作者： Vittorio Bresadola Gian Luigi Adani Francesco Londero Cosimo Alex Leo Vittorio Cherchi Dario Lorenzin Anna Rossetto Gianmatteo Vit Umberto Baccarani Giovanni Terrosu Dino De Anna Department of Surgery and Transplantation University Hospital of Udine

AIM:To investigate differences in the physiopathological findings(manometry and pH monitoring) and symptoms between cases of non-erosive reflux disease(NERD) and erosive reflux disease(ERD) found positive at 24 h pH monitoring. METHODS:For a total of 670 patients who underwent 24 h pH monitoring,esophageal manometry and upper endoscopy were retrospectively evaluated,assessing the reflux symptoms,manometric characteristics of the lower esophageal sphincter(LES) and esophageal body and the presence or absence of esophagitis and hiatal hernia. Typical and atypical symptoms were also evaluated. For inclusion in the study,patients had to have NERD or ERD and be found positive on pH monitoring(NERD+) . Patients with Gastroesophageal reflux disease(GERD) complicated by stenosis,ulcers or Barrett's esophagus were ruled out. RESULTS:214 patients were involved in the study,i.e. 107 cases of NERD+ and 107 of ERD. There were no significant gender-or age-related differences between the two groups. The ERD group had more cases of hiatal hernia(P = 0.02) and more acid reflux,both in terms of number of reflux episodes(P = 0.01) and as a percentage of the total time with a pH 0.05) . The NERD+ patients presented more often with atypical symptoms(P = 0.01) . CONCLUSION:The NERD+ patients' fewer reflux episodes and the fact that they occurred mainly while in the upright position(unlike the cases of ERD) may be two factors that do not favor the onset of esophagitis. The frequently atypical symptoms seen in patients with NERD+ need to be accurately evaluated for therapeutic purposes because patients with GERD and atypical symptoms generally respond only partially to medical and surgical treatments.

关键词： Gastroesophageal reflux disease non-erosive reflux disease erosive reflux disease Barrett’s esophagus Reflux symptoms

Esomeprazole regimens for reflux symptoms in Chinesepatients with chronic gastrit

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2015年第22期21卷 6965-6973页

作者： Jing Sun YaoZong Yuan XiaoHua Hou DuoWu Zou Bin Lu MinHu Chen Fei Liu KaiChun Wu XiaoPing Zou YanQing Li LiYa Zhou Jing Sun Yao-Zong Yuan Department of Gastroenterology Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200025 China.

AIM To compare symptom control with esomeprazoleregimens for non-erosive reflux disease and chronicgastritis in patients with a negative endoscopy.METHODS： This randomized, open-label study wasdesigned in line with clinical practice in China. Patientswith typical reflux symptoms for ≥ 3 mo and a negativeendoscopy who had a Gastroesophageal Reflux DiseaseQuestionnaire score ≥ 8 were randomized to initialtreatment with esomeprazole 20 mg once daily eitherfor 8 wk or for 2 wk. Patients with symptom reliefcould enter another 24 wk of maintenance/on-demandtreatment, where further courses of esomeprazole 20mg once daily were given if symptoms recurred. Theprimary endpoint was the symptom control rate at week24 of the maintenance/on-demand treatment period.Secondary endpoints were symptom relief rate, successrate （defined as patients who had symptom reliefafter initial treatment and after 24 wk of maintenancetreatment）, time-to-first-relapse and satisfaction rate.RESULTS： Based on the data collected in the modifiedintention-to-treat population （MITT; patients in the ITTpopulation with symptom relief after initial esomeprazoletreatment, n = 262）, the symptom control rate showeda small but statistically significant difference in favorof the 8-wk regimen （94.9% vs 87.3%, P = 0.0473）.Among the secondary endpoints, based on the datacollected in the ITT population （n = 305）, the 8-wkgroup presented marginally better results in symptomrelief after initial esomeprazole treatment （88.3% vs83.4%, P = 0.2513） and success rate over the wholestudy （83.8% vs 72.8%, P = 0.0258）. The 8-wkregimen was found to provide a 46% reduction in riskof relapse vs the 2-wk regimen （HR = 0.543; 95%CI：0.388-0.761）. In addition, fewer unscheduled visits andhigher patient satisfaction supported the therapeuticbenefits of the 8-wk regimen over the 2-wk regimen.Safety was comparable between the two groups, withboth regimens being well tolerated.CONCLUSION： Chinese patients diagnosed withchronic gastritis achieved marginally better control ofreflux sympt

关键词： Esomeprazole non-erosive reflux diseaseregimen Chronic gastritis regimen Symptom controlrate